| Hepatic Subcapsular Steatosis in a Diabetic CAPD Patient Receiving Subcutaneous Insulin |
| Seung Yup Lee, M.D.1, Hyun Kyung Kim, M.D.1, Seung Mo Kang, M.D.1, Jong Kwan Jung, M.D.1, Eun Ju Song, M.D.1, 2 and So Young Lee, M.D.1, 2 |
Eulji University School of Medicine1
Division of Nephrology2
Department of Internal Medicine, Eulji Medical Center, Korea |
| 증례 : 피하 인슐린 치료 중이던 지속성 복막투석 환자에서 발생한 간피막하 지방증 1예 |
| 이승엽1, 김현경1, 강승모1, 정종관1, 송은주1, 2, 이소영1, 2 |
| 을지대학교 의과대학 내과학교실1 , 을지병원 신장내과2 |
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| Abstract |
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Hepatic subcapsular steatosis is a rare and unique form of fatty change in the liver. It is a specific finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin and high glucose cause a unique pattern of fatty infiltration in the subcapsular location of the liver. We report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who has not received intraperitoneal insulin. A 63-year-old diabetic woman on CAPD presented with uncontrolled blood glucose. The patient received a total amount of 44 units of NPH via subcutaneous injection. Her initial blood chemistry showed mildly increased serum lipid profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We report a case of hepatic subcapsular steatosis in a diabetic patient not taking intraperitoneal insulin who recovered through strict blood sugar control without changing dialysis modality. |
| Key Words:
Fatty liver, Peritoneal dialysis, Diabetes mellitus |
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